Provider Demographics
NPI:1417836131
Name:SHAPIRO, MOLLY (LCSW)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3514 LANCASTER AVE APT 214
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4921
Mailing Address - Country:US
Mailing Address - Phone:314-619-1478
Mailing Address - Fax:
Practice Address - Street 1:107 CHESLEY DR STE 2
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-1760
Practice Address - Country:US
Practice Address - Phone:484-278-1071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0260531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical